39,213 results match your criteria renal clearance

Local antifungal immunity in the kidney in disseminated candidiasis.

Curr Opin Microbiol 2021 May 12;62:1-7. Epub 2021 May 12.

Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA. Electronic address:

Disseminated candidiasis is a hospital-acquired infection that results in high degree of mortality despite antifungal treatment. Autopsy studies revealed that kidneys are the major target organs in disseminated candidiasis and death due to kidney damage is a frequent outcome in these patients. Thus, the need for effective therapeutic strategies to mitigate kidney damage in disseminated candidiasis is compelling. Read More

View Article and Full-Text PDF

Successful use of azithromycin for Escherichia coli-associated renal allograft malakoplakia: a report of two cases.

Eur J Clin Microbiol Infect Dis 2021 May 14. Epub 2021 May 14.

Department of Infectious Diseases, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.

Malakoplakia is a chronic granulomatous disease associated with incomplete clearance of bacterial pathogens. A multimodal approach to therapy includes antimicrobials with intracellular activity, reduction in immunosuppression, and debulking of lesions. Azithromycin has an intracellular mechanism of action and enhanced Gram-negative activity compared to other macrolides. Read More

View Article and Full-Text PDF

Conversion of RNA Aptamer into Modified DNA Aptamers Provides for Prolonged Stability and Enhanced Antitumor Activity.

J Am Chem Soc 2021 May 14. Epub 2021 May 14.

Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States.

Aptamers, synthetic single-strand oligonucleotides that are similar in function to antibodies, are promising as therapeutics because of their minimal side effects. However, the stability and bioavailability of the aptamers pose a challenge. We developed aptamers converted from RNA aptamer to modified DNA aptamers that target phospho-AXL with improved stability and bioavailability. Read More

View Article and Full-Text PDF

Radiation Increases Bioavailability of Lisinopril, a Mitigator of Radiation-Induced Toxicities.

Front Pharmacol 2021 27;12:646076. Epub 2021 Apr 27.

Institute for Health and Equity, Division of Biostatistics, Medical College of WI, Milwaukee, WI, United States.

There are no FDA-approved drugs to mitigate the delayed effects of radiation exposure that may occur after a radiological attack or nuclear accident. To date, angiotensin-converting enzyme inhibitors are one of the most successful candidates for mitigation of hematopoietic, lung, kidney, and brain injuries in rodent models and may mitigate delayed radiation injuries after radiotherapy. Rat models of partial body irradiation sparing part of one hind leg (leg-out PBI) have been developed to simultaneously expose multiple organs to high doses of ionizing radiation and avoid lethal hematological toxicity to study the late effects of radiation. Read More

View Article and Full-Text PDF

Long-term renal outcome in methylmalonic acidemia in adolescents and adults.

Orphanet J Rare Dis 2021 May 13;16(1):220. Epub 2021 May 13.

Adult Nephrology and Transplantation Department, Hôpital Necker Enfants Malades, APHP, 149 rue de Sèvres, 75015, Paris, France.

Background: Chronic kidney disease (CKD) is one of the main long-term prognosis factors in methylmalonic acidemia (MMA), a rare disease of propionate catabolism. Our objective was to precisely address the clinical and biological characteristics of long-term CKD in MMA adolescent and adult patients.

Patients And Methods: In this retrospective study, we included MMA patients older than 13 years who had not received kidney and/or liver transplantation. Read More

View Article and Full-Text PDF

Effect of Experimental Fanconi Syndrome on Tubular Reabsorption of Lithium in Rats.

Pharmacology 2021 May 12:1-5. Epub 2021 May 12.

Department of Pharmaceutics, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan.

Lithium, administered to patients of bipolar disorders, is mainly excreted into urine, and tubular reabsorption at the proximal tubule is involved in the renal handling of lithium. In this study, we examined the renal excretion of lithium in rats with Fanconi syndrome, characterized by defects of transports of various compounds at the proximal tubules, induced by maleic acid. After maleic acid was intravenously injected, mannitol and lithium chloride were infused in turn. Read More

View Article and Full-Text PDF

Innate Immune Invisible Ultrasmall Gold Nanoparticles-Framework for Synthesis and Evaluation.

ACS Appl Mater Interfaces 2021 May 12. Epub 2021 May 12.

Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge CB3 0AS, U.K.

Nanomedicine is seen as a potential central player in the delivery of personalized medicine. Biocompatibility issues of nanoparticles have largely been resolved over the past decade. Despite their tremendous progress, less than 1% of applied nanosystems can hit their intended target location, such as a solid tumor, and this remains an obstacle to their full ability and potential with a high translational value. Read More

View Article and Full-Text PDF

Pharmacokinetics Parameters of Diagoxin among Saudi Patients in Qassim Region, Saudi Arabia.

Drug Metab Lett 2021 May 6. Epub 2021 May 6.

Department of Respiratory Medicine, Our Lady of Lourdes Hospital, Drogheda, Ireland.

Background: The pharmacodynamic effects of digoxin are susceptible to multiple factors, most notably, heart uptake of the digoxin dose and its concentration in the serum. Another important factor to mention is the renal function state of an individual.

Objective: In this study, we aimed to develop a simple algorithm based on subsets of clinically relevant information, which will help to personalize digoxin based on pharmacokinetic (PK) approach, which can help on marketing the appropriate utilization of this medication. Read More

View Article and Full-Text PDF

Deviant Dosing: A Post hoc Analysis of Pharmacist Characteristics Related to Renal Dosing Decisions.

Ann Pharmacother 2021 May 8:10600280211016328. Epub 2021 May 8.

Wayne State University, Detroit, MI, USA.

Background: A recent study demonstrated that pharmacists presented with multiple estimating equations deviated from recommended dosing guidance more often than pharmacists who were presented with a single estimate on clinical vignettes.

Objectives: To identify characteristics associated with an increased tendency to deviate from approved recommendations.

Methods: Participant data were split into 2 cohorts: pharmacists who chose a dose that was inconsistent with dosing recommendations on at least 1 of the 4 vignettes and pharmacists who did not deviate on a single case. Read More

View Article and Full-Text PDF

Short Term Prognosis of Renal Artery Stenosis Secondary to Acute Type B Aortic Dissection With TEVAR.

Front Cardiovasc Med 2021 23;8:658952. Epub 2021 Apr 23.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

To determine the effect of renal artery stenosis (RAS) resulting from acute type B aortic dissection (ATBAD) with thoracic endovascular aortic repair (TEVAR) on early prognosis in patients with ATBAD. A total of 129 ATBAD patients in the National Acute Aortic Syndrome Database (AASCN) who underwent TEVAR between 2019 and 2020 were enrolled in our study. Patients were divided into two groups: the RAS group and the non-RAS group. Read More

View Article and Full-Text PDF

Gestational and Breastfeeding Low-Protein Intake on Blood Pressure, Kidney Structure, and Renal Function in Male Rat Offspring in Adulthood.

Front Physiol 2021 22;12:658431. Epub 2021 Apr 22.

Fetal Programming and Hydroelectrolyte Metabolism Laboratory, Nucleus of Medicine and Experimental Surgery, Department of Internal Medicine, Faculty of Medical Sciences at State University of Campinas, Campinas, Brazil.

: Our previous studies demonstrated that maternal protein-restricted (low-protein, LP) 16-week-old offspring had pronounced nephron number reduction and arterial hypertension associated with an unchanged glomerular filtration rate (GFR). An enhanced gomerular area may be related to increased glomerular filtration and overflow, which accounts for glomerular filtration barrier breakdown and early glomerulosclerosis. The effect of protein restriction during gestational and breastfeeding periods is unknown. Read More

View Article and Full-Text PDF

Serum Creatinine and Serum Cystatin C are Both Relevant Renal Markers to Estimate Vancomycin Clearance in Critically Ill Neonates.

Front Pharmacol 2021 19;12:634686. Epub 2021 Mar 19.

Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland.

Serum creatinine (SCr) is used as a marker of kidney function to guide dosing of renally eliminated drugs. Serum Cystatin C (S-CysC) has been suggested as a more reliable kidney marker than SCr in adults and children. Purpose of this study was to investigate S-CysC as alternative renal marker to SCr for estimating vancomycin clearance in neonates undergoing intensive care. Read More

View Article and Full-Text PDF


J Pharmacol Exp Ther 2021 May 7. Epub 2021 May 7.

Pharmaceutical Sciences, University at Buffalo, United States

The drug of abuse, γ-hydroxybutyric acid (GHB), is commonly co-ingested with ethanol, resulting in a high incidence of toxicity and death. Our laboratory has previously reported that GHB is a substrate for the monocarboxylate transporters (MCT), necessary for its absorption, renal clearance, and tissue distribution, including across the blood-brain barrier. Our goal was to investigate the drug-drug interaction (DDI) between GHB-ethanol and evaluate MCT1 inhibition as a strategy to reverse toxicity. Read More

View Article and Full-Text PDF

Population Pharmacokinetics of CC-122.

Clin Pharmacol 2021 28;13:61-71. Epub 2021 Apr 28.

Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Summit, NJ, USA.

Background: CC-122 is a cereblon-modulating agent that exerts direct cell-autonomous activity against malignant B cells and immunomodulatory effects. Herein, a population pharmacokinetic (popPK) model of CC-122 was developed and the influence of demographic and disease-related covariates on population pharmacokinetic parameters was assessed based on data from three clinical studies of CC-122 (dose range, 0.5-15 mg) in healthy subjects and cancer patients. Read More

View Article and Full-Text PDF

Sustained Release Systems for Delivery of Therapeutic Peptide/Protein.

Biomacromolecules 2021 May 6. Epub 2021 May 6.

Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao 266100, China.

Peptide/protein therapeutics have been significantly applied in the clinical treatment of various diseases such as cancer, diabetes, . owing to their high biocompatibility, specificity, and therapeutic efficacy. However, due to their immunogenicity, instability stemming from its complex tertiary and quaternary structure, vulnerability to enzyme degradation, and rapid renal clearance, the clinical application of protein/peptide therapeutics is significantly confined. Read More

View Article and Full-Text PDF

The combination of vitamin D3 and erythropoietin alleviates acute kidney injury induced by ischemia-reperfusion via inhibiting inflammation and apoptosis.

Iran J Basic Med Sci 2021 Feb;24(2):167-174

Department of Nephrology, Guizhou Provincial People's Hospital & NHC Key Laboratory of Pulmonary Immunological Disease (Guizhou Provincial People's Hospital), Guiyang, Guizhou, 550002, P.R. China.

Objectives: Acute renal ischemia may cause acute renal dysfunction due to lack of blood supply; the manifestations are renal tubular cell apoptosis, infiltration of macrophages, and microvascular destruction. Many studies have shown that erythropoietin (EPO) and vitamin D3 (VD3) can be used to prevent or treat renal ischemia-reperfusion (I/R) injury, and VD3 may interact with EPO. In the present study, the effects of the combination of VD3 and EPO in I/R acute kidney injury were studied. Read More

View Article and Full-Text PDF
February 2021

Dosing Optimization of Ampicillin-Sulbactam Based on Cystatin C in Elderly Patients with Pneumonia.

Biol Pharm Bull 2021 ;44(5):732-736

Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University.

Ampicillin-sulbactam is a first-line therapy for pneumonia and is mainly excreted by the kidney. It is important to optimize the dose and dosing interval of ampicillin-sulbactam because in patients with decreased renal function and low skeletal muscle mass, such as the elderly, excess drug may burden renal function. In this study, we evaluated indices of renal function and optimized the dose and dosing interval of ampicillin-sulbactam based on pharmacokinetics (PK) and pharmacodynamics theory in elderly patients. Read More

View Article and Full-Text PDF
January 2021

Lacosamide induced Brugada I morphology in the setting of septicemia: A case report.

Medicine (Baltimore) 2021 May;100(18):e25577

Department of Laboratory Medicine.

Introduction: Brugada syndrome may be unmasked by non-antiarrhythmic pharmaceuticals or drugs. Lacosamide is an antiepileptic agent with a novel mechanism of sodium channel inhibition and has the potential to cause cardiac sodium channel blockade.

Patient Concerns: In this report, we describe the case of patient with a history of a seizure disorder who presented with Brugada I electrocardiogram morphology in the setting of septicemia. Read More

View Article and Full-Text PDF

Methods for dose quantification in continuous renal replacement therapy: towards a more precise approach.

Artif Organs 2021 May 5. Epub 2021 May 5.

Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Italy.

Periodic dose assessment is quintessential for dynamic dose adjustment and quality control of continuous renal replacement therapy (CRRT) in critically ill patients with acute kidney injury (AKI). The flows-based methods to estimate dose are easy and reproducible methods to quantify (estimate)CRRT dose at the bedside. In particular, quantification of effluent flow and, mainly, the current dose (adjusted for dialysate, replacement, blood flows and net ultrafiltration) is routinely used in clinical practice. Read More

View Article and Full-Text PDF

Estimation of Ontogeny Functions for Renal Transporters Using a Combined Population Pharmacokinetic and Physiology-Based Pharmacokinetic Approach: Application to OAT1,3.

AAPS J 2021 May 4;23(3):65. Epub 2021 May 4.

Division of Systems Biomedicine and Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands.

To date, information on the ontogeny of renal transporters is limited. Here, we propose to estimate the in vivo functional ontogeny of transporters using a combined population pharmacokinetic (popPK) and physiology-based pharmacokinetic (PBPK) modeling approach called popPBPK. Clavulanic acid and amoxicillin were used as probes for glomerular filtration, combined glomerular filtration, and active secretion through OAT1,3, respectively. Read More

View Article and Full-Text PDF

Aminoglycosides in the Intensive Care Unit: What Is New in Population PK Modeling?

Antibiotics (Basel) 2021 Apr 29;10(5). Epub 2021 Apr 29.

Faculté de Pharmacie, Université de Montréal, Montréal, QC H3T 1J4, Canada.

Background: Although aminoglycosides are often used as treatment for Gram-negative infections, optimal dosing regimens remain unclear, especially in ICU patients. This is due to a large between- and within-subject variability in the aminoglycoside pharmacokinetics in this population.

Objective: This review provides comprehensive data on the pharmacokinetics of aminoglycosides in patients hospitalized in the ICU by summarizing all published PopPK models in ICU patients for amikacin, gentamicin, and tobramycin. Read More

View Article and Full-Text PDF

Comparative evaluation of upper versus lower calyceal approach in percutaneous nephrolithotomy (PCNL) for managing renal calculi.

J Pak Med Assoc 2021 Feb;71(2(B)):602-607

College of Physicians and Surgeons of Pakistan, Karachi.

Objective: To compare upper versus lower calyceal approaches in percutaneous nephrolithotomy for managing renal calculi.

Methods: The retrospective study was conducted in the Department of Urology, The Kidney Centre Post-Graduate Training Institute, Karachi, and comprised data of patients who underwent percutaneous nephrolithotomy from January 2014 to January 2015. Patients were divided into upper pole puncture group A and lower pole puncture group B. Read More

View Article and Full-Text PDF
February 2021

Drug dosing considerations in continuous renal replacement therapy.

Semin Dial 2021 May 3. Epub 2021 May 3.

Clinical Pharmacy, UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA.

Acute kidney injury (AKI) is a common complication in critically ill patients, which is associated with increased in-hospital mortality. Delivering effective antibiotics to treat patients with sepsis receiving continuous renal replacement therapy (RRT) is complicated by variability in pharmacokinetics, dialysis delivery, lack of primary literature, and therapeutic drug monitoring. Pharmacokinetic alterations include changes in absorption, distribution, protein binding (PB), metabolism, and renal elimination. Read More

View Article and Full-Text PDF

Augmented Renal Clearance in a Case of Sepsis Leading to Vancomycin Failure Despite Increasing Dose As per the Estimated Glomerular Filtration Rate.

Cureus 2021 Mar 30;13(3):e14183. Epub 2021 Mar 30.

Internal Medicine, Interfaith Medical Center, Brooklyn, USA.

Augmented renal clearance (ARC) is a unique clinical scenario observed in critically ill patients. We present a case of a 30-year-old male with sepsis secondary to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia treated with vancomycin. ARC was observed in the patient with a maximum estimated glomerular filtration rate (eGFR) of 161. Read More

View Article and Full-Text PDF

Head to head comparison of [Tc]Tc(CO)(NTA) and [Tc]Tc-MAG3 in patients with suspected obstruction.

EJNMMI Res 2021 May 1;11(1):43. Epub 2021 May 1.

Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, 30322, USA.

Purpose: Tc-tricarbonyl-nitrilotriacetic acid, [Tc]Tc(CO)(NTA), is a new Tc-renal radiopharmaceutical with a clearance equal to that of I-ortho-iodohippuran, [I]I-OIH. Our purpose was to compare the performance of [Tc]Tc(CO)(NTA) and [Tc]Tc-MAG3 in patients with suspected obstruction.

Methods: [Tc]Tc(CO)(NTA) was prepared with commercially available NTA ligand and CRS Isolink kit, and isolated by HPLC. Read More

View Article and Full-Text PDF

Endothelin Antagonism and Sodium Glucose Co-transporter 2 Inhibition A Potential Combination Therapeutic Strategy for COVID-19.

Pulm Pharmacol Ther 2021 Apr 29:102035. Epub 2021 Apr 29.

Division of Experimental Medicine & Immunotherapeutics, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK; Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK.

The novel coronavirus 2019 (COVID-19) infection caused by SARS-CoV-2 is a global pandemic that requires a multi-faceted approach to tackle this unprecedent health crisis. Therapeutics to treat COVID-19 are an integral part of any such management strategy and there is a substantial unmet need for treatments for individuals most at risk of severe disease. This perspective review provides rationale of a combined therapeutic regimen of selective endothelin-A (ET-A) receptor antagonism and sodium glucose co-transporter-2 (SGLT-2) inhibition to treat COVID-19. Read More

View Article and Full-Text PDF

The predictive value of creatinine clearance for mortality in patients undergoing revascularization.

J Cardiothorac Surg 2021 May 1;16(1):120. Epub 2021 May 1.

Department of Cardiac Surgery, Leviev Cardiothoracic and Vascular Center, 52621, Tel Hashomer, Israel.

Background: Renal function plays a significant role in the prognosis and management of patients with multi-vessel coronary artery disease (CAD) referred for revascularization. Current data lack precise risk stratification using estimated glomerular filtration rate (eGFR) and creatinine clearance.

Methods: This prospective study includes a three-year follow-up of 1112 consecutive patients with multi-vessel CAD enrolled in the 22 hospitals in Israel that perform coronary angiography. Read More

View Article and Full-Text PDF

Nemonoxacin Dosage Adjustment in Patients with Severe Renal Impairment Based on Population Pharmacokinetic and Pharmacodynamic Analysis.

Br J Clin Pharmacol 2021 Apr 30. Epub 2021 Apr 30.

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.

Aims: To optimize the dosing regimen in patients with severe renal impairment based on population pharmacokinetic/pharmacodynamic (PPK/PD) analysis.

Methods: The pharmacokinetics and safety of nemonoxacin was evaluated in a single-dose, open-label, nonrandomized, parallel-group study after single oral dose of 0.5 g nemonoxacin capsule in 10 patients with severe renal impairment and 10 healthy controls. Read More

View Article and Full-Text PDF

Pharmacokinetics of Selinexor: The First-in-Class Selective Inhibitor of Nuclear Export.

Clin Pharmacokinet 2021 Apr 29. Epub 2021 Apr 29.

Karyopharm Therapeutics, 85 Wells Ave, Newton, MA, 02459, USA.

The functionality of many tumor suppressor proteins (TSPs) and oncoprotein transcript RNAs largely depend on their location within the cell. The exportin 1 complex (XPO1) transports many of these molecules from the nucleus into the cytoplasm, thereby inactivating TSPs and activating oncoprotein transcript RNAs. Aberrations of these molecules or XPO1 can increase this translocation process, leading to oncogenesis. Read More

View Article and Full-Text PDF

Continuation of Over-the-Counter Biotin Supplements in the Inpatient Setting: An Unexpected Source of Laboratory Error.

J Appl Lab Med 2021 Apr;6(3):735-742

Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA.

Background: Over the past decade, use of high-dose biotin has increased significantly and can lead to erroneous results on some clinical immunoassays. In collaboration with pharmacists at our institution, we discovered that high biotin doses were being administered to inpatients as a continuation of patient-reported home biotin use.

Methods: This retrospective study evaluated high-dose biotin administration in 226 inpatient encounters from 2009 to 2019 and its potential impact on concurrent immunoassay testing. Read More

View Article and Full-Text PDF